Why Do PTSD Rates Vary Depending On Trauma?

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What is Betrayal Trauma Theory?

History of Terminology

Jennifer Freyd introduced the terms "betrayal trauma" and "betrayal trauma theory" in 1991 at a presentation at Langley Porter Psychiatric Institute:

Freyd, J.J. Memory repression, dissociative states, and other cognitive control processes involved in adult sequelae of childhood trauma. Invited paper given at the Second Annual Conference on A Psychodynamics - Cognitive Science Interface, Langley Porter Psychiatric Institute, University of California, San Francisco, August 21-22, 1991.

From that talk: "I propose that the core issue is betrayal -- a betrayal of trust that produces conflict between external reality and a necessary system of social dependence. Of course, a particular event may be simultaneously a betrayal trauma and life threatening. Rape is such an event. Perhaps most childhood traumas are such events." Betrayal trauma theory was introduced: "The psychic pain involved in detecting betrayal, as in detecting a cheater, is an evolved, adaptive, motivator for changing social alliances. In general it is not to our survival or reproductive advantage to go back for further interaction to those who have betrayed us. However, if the person who has betrayed us is someone we need to continue interacting with despite the betrayal, then it is not to our advantage to respond to the betrayal in the normal way. Instead we essentially need to ignore the betrayal....If the betrayed person is a child and the betrayer is a parent, it is especially essential the child does not stop behaving in such a way that will inspire attachment. For the child to withdraw from a caregiver he is dependent on would further threaten his life, both physically and mentally. Thus the trauma of child abuse by the very nature of it requires that information about the abuse be blocked from mental mechanisms that control attachment and attachment behavior. One does not need to posit any particular avoidance of psychic pain per se here -- instead what is of functional significance is the control of social behavior. "

"The role of betrayal in betrayal trauma theory was initially considered an implicit but central aspect of some situations. If a child is being mistreated by a caregiver he or she is dependent upon, this is by definition betrayal, whether the child recognizes the betrayal explicitly or not. Indeed, the memory impairment and gaps in awareness that betrayal trauma theory predicted were assumed to serve in part to ward off conscious awareness of mistreatment in order to promote the dependent child's survival goals......While conscious appraisals of betrayal may be inhibited at the time of trauma and for as long as the trauma victim is dependent upon the perpetrator, eventually the trauma survivor may become conscious of strong feelings of betrayal."

 

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Military Sexual Trauma: Issues in Caring for Veterans

from the National Center for PTSD

This is Google's cache of the page.

A National Center for PTSD Fact Sheet

Amy Street, Ph.D. and Jane Stafford, Ph.D.

What is Military Sexual Trauma? Military sexual trauma refers to both sexual harassment and sexual assault that occurs in military settings. Both men and women can experience military sexual trauma and the perpetrator can be of the same or of the opposite gender. A general definition of sexual harassment is unwelcome verbal or physical conduct of a sexual nature that occurs in the workplace or an academic or training setting. Sexual harassment includes gender harassment (e.g., put you down because of your gender), unwanted sexual attention (e.g., made offensive remarks about your sexual activities or your body) and sexual coercion (e.g., implied special treatment if you were sexually cooperative). Sexual assault is any sort of sexual activity between at least two people in which one of the people is involved against his or her will. Physical force may or may not be used. The sexual activity involved can include many different experiences including unwanted touching, grabbing, oral sex, anal sex, sexual penetration with an object, and/or sexual intercourse.

People tend to think that only women experience sexual trauma, however, this is not the case. In 1995 the Department of Defense conducted a large study of sexual victimization among active duty populations and found rates of sexual harassment to be 78% among women and 38% among men over a one-year period. Rates of attempted or completed sexual assault were 6% for women and 1% for men. Rates of military sexual trauma among veteran users of VA healthcare appear to be even higher than in general military populations. In one study, 23% of female users of VA healthcare reported experiencing at least one sexual assault while in the military.

Does Military Sexual Trauma Occur during Wartime?

Sexual trauma in the military does not occur only during training or peacetime and in fact, the stress of war may be associated with increases in rates of sexual harassment and assault.Research with Persian Gulf War military personnel conducted by Jessica Wolfe and her colleagues found that rates of sexual assault (7%), physical sexual harassment (33%) and verbal sexual harassment (66%) were higher than those typically found in peacetime military samples.
Are There Unique Aspects of Sexual Trauma Associated with Military Service?

While there is almost no empirical data comparing experiences of military sexual trauma with experiences of sexual harassment and assault that occur outside of military service, there is some anecdotal evidence that these experiences are unique and may be associated with qualitatively or quantitatively different psychological outcomes.

Sexual trauma that is associated with military service most often occurs in a setting where the victim lives and works.In most cases, this means that victims must continue to live and work closely with their perpetrators, often leading to an increased sense of feeling helpless, powerless, and at risk for additional victimization. In addition, sexual victimization that occurs in this setting often means that victims are relying on their perpetrators (or associates of the perpetrator) to provide for basic needs including medical and psychological care. Similarly, because military sexual trauma occurs within the workplace, this form of victimization disrupts the career goals of many of its victims. Perpetrators are frequently peers or supervisors responsible for making decisions about work-related evaluations and promotions. In addition, victims are often forced to choose between continuing military careers during which they are forced to have frequent contact with their perpetrators or sacrificing their career goals in order to protect themselves from future victimization.

Most military groups are characterized by high unit cohesion, particularly during combat. While this level of solidarity typically reflects a positive aspect of military service, the dynamics of cohesion may play a role in the negative psychological effects associated with sexual harassment and assault that occurs. Because organizational cohesion is so highly valued within the military environment, divulging any negative information about a fellow soldier is considered taboo. Accordingly, many victims are reluctant to report sexual trauma and many victims say that there were no available methods for reporting their experiences to those in authority. Many indicate that if they did report the harassment they were not believed or encouraged to keep silent about the experience. They may have had their reports ignored, or even worse, have been themselves blamed for the experience. Having this type of invalidating experience following a sexual trauma is likely to have a significant negative impact on the victim’s post-trauma adjustment.
What Type of Psychological Responses are Associated with Military Sexual Trauma Victimization?

Given the range of sexual victimization experiences that veterans report (ranging from inappropriate sexual jokes or flirtation, to pressure for sexual favors, to completed forcible rape) there are a wide range of emotional reactions reported by veterans in response to these events. Even in the aftermath of severe forms of victimization, there is no one way that victims will respond. Instead, the intensity, duration, and trajectory of psychological responses will all vary based on factors like the veterans’ previous trauma history, their appraisal of the traumatic event, and the quality of their support systems following the trauma. In addition, the victim’s gender may play a role in the intensity of the post-trauma reactions. While the types of psychological reactions experienced by men and women are often similar, the experience of sexual victimization may be even more stigmatizing for men than it is for women because these victimization experiences fall so far outside of the proscribed male gender role. Accordingly, men may experience more severe symptomatology than women, may be more likely to feel shame about their victimization, and may be less likely to seek professional help.

Among both men and women in the active duty military, sexual harassment is associated with poorer psychological well-being, more physical problems and lower satisfaction with health and work. Female veterans who use VA healthcare and report a history of sexual trauma while in the military also report a range of negative outcomes, including poorer psychological and physical health, more readjustment problems following discharge (i.e., difficulties finding work, alcohol and drug problems), and a greater incidence of not working due to mental health problems. Studies of sexual assault among civilian populations identify posttraumatic stress disorder (PTSD) as a frequent outcome. Sexual assault victimization is associated with high lifetime rates of PTSD in both men (65%) and women (45.9%). Interestingly, these rates are higher than the rate reported by men following combat exposure (38.8%). Major depressive disorder (MDD) is another common reaction following sexual assault, with research suggesting that almost a third of sexual assault victims have at least one period of MDD during their lives. Victims of sexual assault may also report increased substance use, perhaps as a means of managing other psychological symptoms. One large-scale study found that compared to non-victims, rape survivors were 3.4 times more likely to use marijuana, 6 times more likely to use cocaine, and 10 times more likely to use other major drugs. In addition to these psychological conditions, victims of sexual trauma may continue to struggle with a range of other symptoms that interfere with their quality of life. Common emotional reactions include anger and shame, guilt or self-blame. Victims of sexual trauma may report problems in their interpersonal relationships, including difficulties with trust, difficulties engaging in social activities or sexual dysfunction. Male victims of sexual trauma may also express concern about their sexuality or their masculinity.

 

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Trauma Bonding : The Pull to the Perpetrator

By Svali

PLEASE NOTE: This article discusses perpetration, trauma, and cult programming. If you are a survivor, do not read if these subjects are triggering unless with your therapist or a safe person.

I will be writing on an extremely difficult subject, that of trauma bonding, also known as bonding to the perpetrator. This is difficult to do for several reasons. As a child, I was in a state of “captivity to my abuser” as delineated in trauma journals. I was raised in an isolative cult, and bonded heavily to my primary programmers, both my parents, and the trainers that worked with me. Then, as an adult, I continued the vicious cycle when I became a trainer, then a head trainer, and bonded others to me.

Trauma bonding is the issue that is left out of the equation when people ask “Why do cult members recontact their perps? Why do they keep going back for more abuse?” Without understanding chronic trauma, and the effects of trauma bonding, it is impossible to understand the dynamic involved. I will be sharing in this article both from personal memory of methods used, as well as sourcing to the literature on the subject. My greatest hope is that by understanding this often misunderstood subject, that others may be helped to pull out of its insidious pull.

If a person is unable to escape chronic, traumatic abuse, they will eventually begin to bond with their perpetrator(s). This has been well documented in the literature. It will occur because of the dehumanization of the victim, who may reach a state of feeling that they are “robotized” or nonfeeling, combined with a disruption in the capacity for intimacy caused by the trauma.

“ Trauma impels people both to withdraw from close relationships and to seeks them desperately. The profound disruption in basic trust, the common feelings of shame, guilt, and inferiority, and the need to avoid reminders of the trauma that might be found in social life, all foster withdrawal from close relationships. But the terror of the traumatic event intensifies the need for protective attachments. The traumatized person therefore frequently alternates between isolation and anxious clinging to others... “(1)

Many victims of severe and unrelenting trauma, whether domestic violence, incest, or ritual abuse, will find that they feel anxious when alone, and fear abandonment and isolation. The over-dependent characteristics are NOT a personality fault, but a result of the chronic abuse. This is often rooted in the fact that as a child, the trauma survivor was not only a CAPTIVE to their abuse, but they depended upon their perpetrator for food, shelter, or other necessities. In addition, with ritual abuse, a small child will often be abandoned for periods of time, to increase their dependency upon the very people who are abusing them. Any two or three year old will be almost insanely grateful to be rescued from a small box that they have been confined within for hours, or from the dark confines of a musty basement where they have been left for a day or two. Even the most abusive perpetrator will then become the child’s rescuer, which is the foundation of trauma bonding. In trauma bonding, the person’s abuser will be perceived as the one who delivers and rescues from the abuse, as well as the tormentor. This creates a psychological ambivalence that creates dissociation in a young child. The very helplessness and terror that are instilled by the abuse, cause the child (or later, the adult) to reach out to the only available hand for relief: the perpetrator. And the perpetrator WILL rescue and stop the abuse, or take the child out of the confines of their pain, but for a price: their unrelenting loyalty and obedience. This is the traumatic underpinning of all cult programming that I have seen: a combination of abuse and kindness; terror and rescue; degradation and praise.

This will be reinforced by the perceived power of the perpetrator in the cult situation: In situations of captivity, the perpetrator becomes the most powerful person in the life of the victim, and the psychology of the victim is shaped by the actions and beliefs of the perpetrator. (1)

This is survival at its most basic for the child raised in a cult setting, since failure to do this will cause further punishment and pain. The child will have seen people tortured or killed for disobedience, and so, literally, the perpetrator WILL have the perceived power of life and death over the child. If the child complies, and is “obedient” to the demands of their perpetrator and the group, they will be “rewarded”with freedom from punishment and continued life. The intense coercion to not only comply with, but to identify idealistically, with the group in this context is overwhelming. Almost all very young children in an abusive cult setting will begin to internalize their perpetrators in some form in order to cope with this reality. And this reaction will be rewarded heavily, if not done intentionally. Many cult handlers or trainers will pretend to “pass on their spirit” into the child, and will tell the child that they now “live within them” and “are always watching them.” Frequently, the young child will then create an internal alter with the same name as the outside abuser or trainer.

I remember my second trainer, Dr. Brogan, saying that he was giving himself “immortality” by going to “live inside of me” when I created (with his help) an internal Dr.Brogan. This alternate personality became a head internal trainer inside, the same role that Dr. Brogan had on the outside, and part of healing has meant learning that this internal Brogan is actually part of ME and learning that he no longer had to do his old “job” of reprogramming me internally. It has also meant breaking free of the hold that the GOOD memories of him, the kindnesses, the expressions of love and caring, held over me as well, since they bonded me to him, and to the group that he belonged to.

In the cult, it is not uncommon to have a “death ritual” where the child is brought to a near death experience. Afterwards, the “rescuers” are the trainers who talk soothingly to the child, massage him or her with oils, and tell the child that they “owe their life” to them. Not only that, but the warning is given: if the child ever tries to break free, they will return to the state of dying. Other set ups will include burying a child alive in a box or coffin; again, the perpetrators will rescue the horrified child who is almost out of their mind with terror (after several long hours) under one condition: undying loyalty to the group and the rescuers. Traumatized beyond belief, the child readily complies. This time of avowal and loyalty will be buried in a deep, subconscious layer of the mind, and the older adult or survivor may not be aware that part of the draw to the group is the belief that they “owe their life to them.” The subconscious fear needs to be dealt with: that leaving the group does NOT have to mean death, as they were taught in early childhood traumatizations.

After any training session, all Illuminati trainers know that the most important time is the “kindness bonding” after the trauma is over. The best trainers will have kind personas that will come out, talk lovingly to the “subject” and tell them how well they did, how needed the subject is to the group, how “special” and unique they are. Rewards such as a special food, drugs, or a sexual partner will be given as well. This “kindness” after the trauma is the hook that will often draw programmed personalities back to the cult, since some personalities may know only of the rewards and kindness, and will block the abuse. Heavily abused alters have less of an investment in returning to the cult; but heavily rewarded and praised alters will, and must be helped in therapy to see the whole picture.

Siblings and other children will often form a trauma bond with each other, much as soldiers in a war setting, or prisoners, will do. “Twinning” with a non-biological twin will carry this to an extreme. In different situations, the children are allowed to “rescue” each other, increasing their loyalty and bond to each other. They will go through the same programming and torture together, and will feel the bond of “surviving it” together. A “battlefield” mentality may literally develop, as friendships deepen in youth and vows to be willing to die for one another are given and taken. But all too often, these friends and twins and siblings are also forced to traumatize and wound each other, reinforcing another basic cult message: the one who loves you will hurt you.

The survivor who escapes the cult will feel a powerful pull back because of a lifetime of these types of distorted messages. The safe therapist, or non-DID friend, is not hurting them, and this may create a huge dissonance in a person who up until this point had always been taught that “love” meant “pain”. They may doubt the reality of the caring messages of those around them, or need to test their support system over and over. And highly wounded alters, who were bonded to believe that they owe their very life to the ones who have abused them most, may still try to recontact former perpetrators, not believing that life can be different yet.

Undoing a lifetime of this type of teaching and training takes time, patience, perseverance, and prayer. It will stretch the most caring support person as they wonder why the survivor recontacts their abuser. The survivor will feel that they have betrayed themselves, if they find they have recontacted perpetrators, unaware of the powerful pull that trauma bonding may still have on certain alters inside. But with caring support and continued therapy, the survivor will begin to test old beliefs. Personalities formerly loyal to the father, mother, or other trainers may decide to cut off contact, and will go increasingly long periods without being reaccessed. They may come out in therapy, angry and disgruntled, or asking when the therapist is going to “put down their façade” and begin hurting them (this is another form of testing). The person’s whole world view may go through a 180 degree inside as they realize that love does NOT have to mean abuse, and the message reaches the deepest layers inside. Deep grieving over the abuse of trust, over the betrayals, over the intentionality of the trauma bonding and the set-ups will occur, as the person moves towards healing and away from the pull of their former abusers. The process takes time, often years, to occur, but the result, which is a life free from cult abuse, is well worth it.

References:

1. Trauma : site at http://tor-pw1.attcanada.ca/~lrs/info/tr... excerpt from excellent book Trauma and Recovery (1997) by Judith Lewis Herman, MD

2. Attachment and Bonding Center of Oklahoma: site at http://www.abcok.org/attachment_disorder... Good discussion of attachment disorder and causes in infants

3. The Meadows press release: “The Case for Traumatic Bonding: The Betrayal Bond “by Patrick J. Carnes, Ph.D., C.A.S. Review of book that has an excellent discussion of trauma bonding and emotional betrayal; article has checklist of symptoms of trauma bonding.

 

[becvan]

Interesting. Although not cult related, one thing stuck out in that about siblings. The trauma bond. I have that, with my son. We survived domestic together, He protected me, I protected him.

How many domestics that involve the mother and child do you think end up with the trauma bond?

bec

 

[Roerich]

I suppose students who survived the Colombine tragedy are bonded by that tragedy, surviving as co-victims of a common trauma. The following is what Dr. Carnes considers to be "traumatic bonding".

The Case for Traumatic Bonding: The Betrayal Bond

The following are selected excerpts:

by Dr. Patrick Carnes

About Trauma Bonding:

These people are all struggling with traumatic bonds. Those standing outside see the obvious. All these relationships are about some insane loyalty or attachment. They share exploitation, fear, and danger. They also have elements of kindness, nobility and righteousness. These are all people who stay involved or wish to stay involved with people who betray them. Emotional pain, severe consequences and even the prospect of death do not stop their caring or commitment. Clinicians call this “traumatic bonding.” This means that the victims have a certain dysfunctional attachment that occurs in the presence of danger, shame, or exploitation. There often is seduction, deception or betrayal. There is always some form of danger or risk.

Some relationships are traumatic. Take, for example, the conflictual ties in movies like The War of the Roses orFatal Attraction. What Lucy does to Charlie Brown (in the comic strip, Peanuts) every year when she holds the football for him to kick is a betrayal we have grown to expect. Abuse cycles such as those found in domestic violence are built around trauma bonds. So are the misplaced loyalties found in exploitive cults, incest families, or hostage and kidnapping situations. Codependents who live with alcoholics, compulsive gamblers, or sex addicts, and who will not leave no matter what their partners do, may have suffered enough to have a traumatic bond.

Here are the signs that trauma bonds exist in your life:

When you obsess about people who have hurt you though they are long gone from your life (To obsess means to be preoccupied, fantasize about, and wonder about something/someone even though you do not want to.)

When you continue to seek contact with people whom you know will cause you further pain.

When you go “overboard” to help people who have been destructive to you.

When you continue to be a “team” member when obviously things are becoming destructive.

When you continue attempts to get people who are clearly using you to like you.

When you again and again trust people who have proved to be unreliable.

When you are unable to distance yourself from unhealthy relationships.

When you want to be understood by those who clearly do not care.

When you choose to stay in conflict with others when it would cost you nothing to walk away.

When you persist in trying to convince people that there is a problem and they are not willing to listen.

When you are loyal to people who have betrayed you.

When you are attached to untrustworthy people.

When you keep damaging secrets about exploitation or abuse.

When you continue contact with an abuser who acknowledges no responsibility.

Take Cheryl as an example. Cheryl grew up with a mother who was a compulsive gambler and who supported her addiction by selling sex. The kindest adult in Cheryl’s life was a stepfather who eventually left the craziness of living with her mom. But Cheryl always looked for this kindness. What she was exposed to was a series of abusive men. As an adult she had four marriages, each more abusive that the last. She would find men who were kind and brutal. Between marriages she would deprive herself of food, become thin and would sexually binge. When she was married she would compulsively overeat, gain weight, and become sexually aversive. In every marriage she was beaten. In this last marriage she was sexually tortured. A neighbor had to call the police and storm the door to get her away from her husband. An astute police chaplain got her into treatment. Cheryl was willing to come because even she could finally see a clear pattern.

Here was a professional woman with a master’s degree. She was the mother of four childrenone with each husband. Even in treatment she looked with horror at what her last husband did one minute, but in the next, she would come up with some reason to call him. She would do this even though she could clearly see that any contact with him was dangerous.

About co-dependency:

“Parallels do exist between trauma bonding and codependency because to live with an active addict is often traumatic. For the most part, the addiction field has not incorporated all the trauma research that documents how people grow closer to their abusers in the face of trauma. Yet it is clear that many codependents are also trauma-bonded. The converse is also true. The trauma field has not really addressed issues surrounding addiction, let alone codependency. Yet addiction in its many forms is one of the principal solutions used by survivors to cope with their lives. And most trauma-bonded persons, whether as children or adults, are involved with an abuser who has one or more addictions.”

About shame:

An injury to one’s sense of self forges some bonds. The self-injury becomes part of the fabric of the relationship and further disrupts the natural unfolding of the self. When this involves terror of any sort, an emptiness forms at the core of the person and the self becomes inconsolable. No addiction can fill in. No denial of self will restore it. No single gesture will be believable. Only a profound sense of the human community caring for the self can seal up this hole. We call this wound shame.

 

[becvan]

Ahh okay, Matt and I have a different kind of bond. An "us against them" mindset. Not that unhealthy, although I can see where and with whom, I did have that trauma bond at one point. Broke those thank god.

bec

 

[Roerich]

PTSD Powerpoint presentation by Daniel Brown, Ph.D. (attached to download)

Modifications of the Trauma Bonding Model for Domestic Violence: Dissociation
49-item assessment scale of possible cognitive distortions and coping strategies in young women abused when dating

Results:

Core Stockholm Syndrome

Victim is in a dissociated state characterized by:
Attachment to positive aspects of relationship
Compartmentalization of violent part of relationship
Psychological damage
Depression & low self-esteem
Loss of sense of self
Love-dependence
Feeling cannot survive without partner

Stockholm Syndrome: Explanation

“An automatic, often unconscious, emotional response to the trauma of becoming a victim”
Very high level of life-threatening stress or fear-arousal
Creates situation of extreme, frightened dependency & denial of rage in victim
Re-capitulates early infancy dependency
“The behavior that worked for the dependent infant surfaces again as a means to survival” (p. 152)
Captor is both source of life-threatening and life-giving
Positive contact between victim and captor (captor being “nice”)
Results in the development of a strong, positive emotional bond of victim to captor
Motivated by survival instinct
Beyond control of victim
Belief change
Identify with human qualities of captors-- “a process of humanization” (p. 159)
Increased sympathy with/adoption of captors’ belief system
Increased intolerance for ‘outsider’s’ [normal societal] belief system in general and authorities (police, government) in particular
Development of survival, not escape strategies